The structure of apathy symptoms

Apathy is common in many neurological, psychiatric, and medical disorders and is related to a number of important clinical outcomes. Nonetheless, research on apathy is hindered by different ways of defining and measuring it, which has led to heterogeneity in research findings.

The current study aimed to investigate the factor structure of apathy symptoms using a novel item pool. We examined whether the use of this item pool has incremental validity above and beyond a widely used measure in predicting cognition and everyday functioning. Participants included 249 informants who reported on an individual with (n = 210) or without (n = 39) a neurological or psychiatric condition.

Results showed the best fitting model of apathy symptoms was a bifactor model with apathy as a general dimension and three specific symptom factors including reduced interest and initiative, reduced emotional and verbal expression, and reduced social engagement. Incremental validity in predicting cognition was demonstrated for this more robust assessment of apathy symptoms.

Results are most aligned with one set of proposed diagnostic criteria for apathy which differs from other criteria in that it does not distinguish between cognitive and behavioral symptoms and includes a separate social dimension. Future research could aim to replicate this model in additional clinical samples and explore the incremental validity of the newly developed Apathy Symptom Inventory (ASI) in comparison to other recently developed measures.